Cardiovascular disease

Cardiovascular disease (CVD) is the leading cause of death and disease burden in Australia. The number of people living with cardiovascular disease is increasing due to factors including population ageing and improved treatments that have resulted in people living longer with CVD.

What is cardiovascular disease?

Cardiovascular disease (CVD) is a collective term for diseases of the heart and blood vessels. The term commonly includes diseases such as coronary heart disease, heart failure, cardiomyopathy, congenital heart disease, peripheral vascular disease and stroke. Many of these conditions can be life-threatening.

Coronary heart disease

Also known as ischaemic heart disease, this is the most common form of heart disease in Australia. The two major forms of coronary heart disease are heart attack (also known as acute myocardial infarction) and angina.

A heart attack is caused when blood supply to the heart is blocked completely, often causing damage to the heart muscle and its function.

Angina is a chronic condition where short episodes of chest pain occur periodically, caused by a temporary shortage of blood supply to the heart. Angina is not usually life-threatening, but can be associated with increased risk of heart attack. Top of page

Heart failure & cardiomyopathy

Heart failure is a life-threatening condition that occurs when the heart is unable to maintain a strong enough blood flow to meet the body’s needs. It usually develops over many years, although it can also occur more suddenly. Heart failure can result in chronic tiredness, reduced ability for physical activity and shortness of breath. Cardiomyopathy occurs when the heart muscle becomes thickened, enlarged or stiff which can reduce the effectiveness of the heart. Cardiomyopathy and heart failure commonly occur together.

Congenital heart disease

A broad term for any defect of the heart or central blood vessels that is present from birth. It can include abnormalities of the heart or heart valves, such as a hole between chambers of the heart, or narrowing of major blood vessels, or combinations of disorders.

Peripheral vascular disease

This term refers to disease of large arteries that supply blood to the peripheries and can be caused by blockage of arteries due to cholesterol or fatty substances, or caused by widening of the arteries such as the aorta, which in severe cases can lead to rupture of the arterial wall.

Stroke

Stroke is a type of cerebrovascular disease and occurs when an artery supplying blood to the brain either suddenly becomes blocked or begins to bleed. This may result in part of the brain dying, leading to sudden impairment of one or more capacities, such as speaking, thinking and/or movement. Top of page

How common is cardiovascular disease?

In 2014-15, approximately 4.2 million Australian adults (18.3%) reported having a disease of the circulatory system, including around 1.2 million people with cardiovascular conditions such as stroke and heart disease. Approximately 2.6 million Australians reported having hypertension (high blood pressure) and 430,000 indicated that they had experienced a heart attack at some point in their life. (source 1).

Cardiovascular disease is a leading cause of death in Australia. In 2015, 45,392 (29%) of deaths had an underlying cause of cardiovascular disease. (source 2).

An estimated 69,600 Aboriginal and Torres Strait Islander persons were estimated to have heart disease in 2014-15, equating to 15.7% of the total Indigenous population. This was around triple the rate recorded in the non-Indigenous population. (source 3).

What are the risk factors for cardiovascular disease?

Major risk factors associated with CVD that cannot be modified include advancing age, genetic predisposition, gender and ethnicity. Modifiable risk factors include behavioural factors such as tobacco smoking, insufficient physical activity, poor diet and excessive alcohol consumption. Biomedical factors also play a major role, such as high blood pressure, high blood cholesterol and overweight and obesity.

A number of these risk factors are shared with other chronic diseases, such as diabetes and chronic kidney disease. The interactions between these chronic conditions are complex and not well understood, however it is known that diabetes greatly increases the risk of CVD. People with diabetes have twice the risk of developing CVD as the general population. The prevalence rate of stroke can be up to five times greater, and prevalence of heart attack up to ten times greater, for people with diabetes than for those without diabetes. Top of page

Treatment or management of cardiovascular disease

For many people, a key step in managing cardiovascular disease involves addressing the modifiable risk factors discussed above. Additionally, there are a range of medicines and surgical treatments available for cardiovascular diseases. For example, depending upon the severity of the condition, coronary heart disease can be managed with medications such as aspirin, or treated through coronary artery bypass graft surgery.

Cardiovascular disease programs and initiatives

There is a range of programs and initiatives to support prevention and optimal detection and treatment of CVD. Significant funding is also provided to ensure that quality clinical research is conducted into CVD, and to maintain national monitoring and surveillance measures.

Programs that support CVD management and care include:

The Medicare Benefits Schedule, which provides subsidies for patient care and includes Medicare items for the planning and management of chronic and terminal conditions. Eligible patients can also be referred by a GP for up to five Medicare subsidised allied health services that are directly related to the treatment of their chronic condition, including cardiovascular disease. In order to encourage early detection, diagnosis and intervention for treatable conditions such as heart disease, health assessment items are also available for people aged 45-49 years who are at risk of developing chronic disease, people aged 75 years and older and Aboriginal and Torres Strait Islander people.

The Pharmaceutical Benefits Scheme, which continues to provide subsidies for a range of medicines used in the treatment of, or symptoms associated with, CVD.

Significant investments in CVD research through the National Health and Medical Research Council (NHMRC), with a focus on investigating the causes, effects, impacts and complications of CVD. Improving the care of patients with multiple and complex chronic diseases, including CVD, has also been identified by the NHMRC as a major focus in its 2013-15 Strategic Plan.

Funding is provided to organisations such as the National Stroke Foundation and National Heart Foundation, and through programs which provide support and training to general practitioners and primary health care services. Top of page

Additionally, the Australian Institute of Health and Welfare is funded to support national surveillance and monitoring of vascular disease, including CVD, diabetes and chronic kidney disease, to help reduce the health, social and economic burden of these diseases.